Comparison of Dentoskeletal Changes, Esthetic, and Functional Efficacy of Conventional and Novel Esthetic Twin Block Appliances among Class II Growing Patients: A Pilot Study

Objective:A twin block appliance used for correction of skeletal Class II malocclusion suffers from undesirable dental effects and bulkiness. To overcome these limitations and the need for more esthetic appearance of this appliance, an esthetic twin block was designed and used in patients. This study aimed to compare dentoskeletal changes and esthetic and functional efficacy in patients treated with conventional and newly designed esthetic twin block (CTB and ETB) appliances using cephalometric measurements and a questionnaire.Methods:A pilot study with a 2-arm parallel-randomized double-blind clinical trial was conducted on 24 patients (20 males, 4 females) in the age group of 11-13 years. Subjects were treated with CTB (group 1 [G1]: n=12; mean age=11.67±0.49 years) and ETB (group 2 [G2]: n=12; mean age=11.75±0.62 years) appliances. A modified Pancherz analysis was performed to evaluate skeletal and dental changes. The esthetic and functional efficacy was evaluated by a questionnaire using Likert scale. Wilcoxon and Mann-Whitney U tests were employed for intra and intergroup comparisons respectively (p<0.05).Results:In G1, a significant increase in lower incisor inclination was observed (p<0.05) whereas it was insignificant in G2. The changes were predominantly skeletal in G2 whereas they were both skeletal and dental in G1. ETB was found to be esthetically and functionally acceptable in all the patients while CTB patients were esthetically conscious, lacked confidence and had discomfort and difficulty in eating, chewing and speaking.Conclusion:ETB had greater skeletal effects with a reduced tendency of lower incisor proclination, was esthetically acceptable, and functionally more comfortable than the CTB

Immuno-informatics analysis predicts B and T cell consensus epitopes for designing peptide vaccine against SARS-CoV-2 with 99.82% global population coverage.

The current global pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has taken a substantial number of lives across the world. Although few vaccines have been rolled-out, a number of vaccine candidates are still under clinical trials at various pharmaceutical companies and laboratories around the world. Considering the intrinsic nature of viruses in mutating and evolving over time, persistent efforts are needed to develop better vaccine candidates. In this study, various immuno-informatics tools and bioinformatics databases were deployed to derive consensus B-cell and T-cell epitope sequences of SARS-CoV-2 spike glycoprotein. This approach has identified four potential epitopes which have the capability to initiate both antibody and cell-mediated immune responses, are non-allergenic and do not trigger autoimmunity. These peptide sequences were also evaluated to show 99.82% of global population coverage based on the genotypic frequencies of HLA binding alleles for both MHC class-I and class-II and are unique for SARS-CoV-2 isolated from human as a host species. Epitope number 2 alone had a global population coverage of 98.2%. Therefore, we further validated binding and interaction of its constituent T-cell epitopes with their corresponding HLA proteins using molecular docking and molecular dynamics simulation experiments, followed by binding free energy calculations with molecular mechanics Poisson-Boltzmann surface area, essential dynamics analysis and free energy landscape analysis. The immuno-informatics pipeline described and the candidate epitopes discovered herein could have significant impact upon efforts to develop globally effective SARS-CoV-2 vaccines

Genomic, Proteomic and Phenotypic Biomarkers of COVID-19 Severity::Protocol for a Retrospective Observational Study

Background:Background - Health organisations and countries around the world have found it difficult to control the spread of the coronavirus disease 2019. To minimise the impact on the NHS and improve patient care, there is a drive for rapid tests capable of detecting individuals who are at high risk of contracting severe COVID-19. Early work focused on single omic approaches, highlighting a limited amount of information.Objective:Objective - The Covid Response Study (COVRES, NCT05548829) aims to carry out an integrated multi-omic analysis of factors contributing to host susceptibility to SARS-CoV-2 among a patient cohort of 1000 people from the geographically isolated island of Ireland.Methods:Methods - The protocol below describes the study to be carried out in Northern Ireland (NI-COVRES) by Ulster University, the Republic of Ireland component will be described separately. All participants (n=519) were recruited from the Western Health and Social Care Trust, Northern Ireland, forty patients are also being followed up at 1, 3, 6 and 12 months to assess the longitudinal impact of infection on symptoms, general health, and immune response, this is ongoing. Data will be sourced from whole blood, saliva samples, and clinical data from the Northern Ireland Electronic Care Record, general health questionnaire, and the GHQ12 mental health survey. Saliva and blood samples were processed for DNA and RNA prior to whole genomic sequencing, RNA sequencing, DNA methylation, microbiome, 16S, and proteomic analysis. Multi-omics data will be combined with clinical data to produce sensitive and specific prognostic models of severity risk.Results:Results - An initial profile of the cohort has been completed: n=249 hospitalised and n=270 non-hospitalised patients were recruited, 64% were female, the mean age was 45 years. High levels of comorbidity were evident in the hospitalised cohort, with cardiovascular disease and metabolic and respiratory disorders (P&lt;0.001) being the most significant.Conclusions:Conclusion – This study will provide a comprehensive opportunity to study multi-omic mechanisms of COVID-19 severity in re-contactable participants. Clinical Trial: Trial Registration - The trial has been registered as an observational study on clinicaltrials.gov as NCT05548829. An outline of the trial protocol is included; SPIRIT checklist (Supplementary Figure 1)

Immuno-informatics analysis predicts B and T cell consensus epitopes for designing peptide vaccine against SARS-CoV-2 with 99.82% global population coverage.

The current global pandemic due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has taken a substantial number of lives across the world. Although few vaccines have been rolled-out, a number of vaccine candidates are still under clinical trials at various pharmaceutical companies and laboratories around the world. Considering the intrinsic nature of viruses in mutating and evolving over time, persistent efforts are needed to develop better vaccine candidates. In this study, various immuno-informatics tools and bioinformatics databases were deployed to derive consensus B-cell and T-cell epitope sequences of SARS-CoV-2 spike glycoprotein. This approach has identified four potential epitopes which have the capability to initiate both antibody and cell-mediated immune responses, are non-allergenic and do not trigger autoimmunity. These peptide sequences were also evaluated to show 99.82% of global population coverage based on the genotypic frequencies of HLA binding alleles for both MHC class-I and class-II and are unique for SARS-CoV-2 isolated from human as a host species. Epitope number 2 alone had a global population coverage of 98.2%. Therefore, we further validated binding and interaction of its constituent T-cell epitopes with their corresponding HLA proteins using molecular docking and molecular dynamics simulation experiments, followed by binding free energy calculations with molecular mechanics Poisson-Boltzmann surface area, essential dynamics analysis and free energy landscape analysis. The immuno-informatics pipeline described and the candidate epitopes discovered herein could have significant impact upon efforts to develop globally effective SARS-CoV-2 vaccines

Molar distalization with 2K appliance: one-year follow-up

Correction of class II molars in growing patients with acceptable facial profile can be performed by distalization of maxillary first molars. However, in patients where compliance is difficult intraoral means of molar distalization is required. This case report describes the use and effectiveness of a novel 2K appliance in an 11-year-old female having an orthognathic profile, skeletal Class I relation, and Angle's Class II division 1 malocclusion with crowding of 8 mm and 3 mm in the maxillary and mandibular arches, respectively. Nonextraction treatment was planned with bilateral distalization of the maxillary first molars. The amount of distalization achieved by 2K appliance was 3.5 mm with only 1° distal tipping. The 2K appliance required minimal patient cooperation, produced bodily movement of molars with minimal tipping/rotation, and prevented anchorage loss of the anterior teeth. This 2K molar distalization appliance was found to be an effective technique to control molars in all three planes of space

New generation of color bonding: A comparative in vitro study

Background: Newer available composite resin adhesives have chromatic agents that change their color during setting from pink to colorless. It has an advantage of easy flash removal thus reducing the amount of plaque accumulation and helping patients to maintain better hygiene. Aim: The aim of the present study was to compare shear bond strengths of light-cure orthodontic bonding agents, namely glass ionomer (FujiOrthoLC, GC Orthodontics), conventional composite resin (Transbond XT, 3M Unitek), and color-changing composite resin (Transbond Plus, 3M Unitek) with conventional etch and self-etch primer (Transbond PlusSEP, 3M Unitek). Materials and Methods: Maxillary premolars (n=300) were bonded on the facial surface in five groups. The INSTRON machine was used for shear bond strength testing. Statistical Analysis: Comparison of the mean rank among the groups was done by Kruskal-Wallis one-way analysis of variance (ANOVA). To determine the mean difference among groups, the Mann-Whitney test with Bon Ferroni adjustment was applied. Observations: It was observed that light-cure conventional composite resin with the conventional etchant group had the highest and glass ionomer resin adhesive had the lowest shear bond strength. There was no statistically significant difference between conventional composite used with conventional etchant and color-changing composite resin used with conventional etchant or with self-etch primer. Conclusion: Considering the advantages of a color-changing composite and self-etch primer especially in patients having high DMFT scores or physically and mentally compromised patients unable to maintain their hygiene properly, it was concluded in the present study that it would be the most suitable material for direct bonding

A comparative evaluation of skeletal, dental, and soft tissue changes with skeletal anchored and conventional facemask protraction therapy

Objective: To cephalometrically evaluate and compare the skeletal, dentoalveolar, and soft tissue changes after maxillary protraction with skeletally anchored and conventional facemask. Methods: The data for the study were collected from the pre- and post-treatment records of patients of maxillary retrusion treated with skeletally anchored and conventional facemask therapy. Twenty subjects were included in the study and were categorized into two groups, namely skeletal anchored maxillary protraction (SAMP) group with the mean age of 10.10 ± 1.1 years and conventional facemask maxillary protraction (CFMP) group with the mean age of 9.90 ± 1.1 years. Pre and post-treatment lateral cephalograms were assessed. Results: The data were analyzed by Mann-Whitney test and Wilcoxon signed-rank test. The mean duration of treatment in SAMP group and CFMP group was 5.8 months and 10 months, respectively. The mean forward displacement of the maxilla (vertical point A) was 3.40 ± 1.07 mm in SAMP group and 2.80 ± 0.79 mm in CFMP group. The mandible showed downward and backward rotation in both the groups with more rotation in CFMP group. A significant increase in maxillary incisor inclination was seen in CFMP group as compared to SAMP group. A significant decrease was found in mandibular incisor inclination in both the treatment groups. The soft tissue changes corresponded to underlying skeletal tissue. C onclusions: SAMP is proven to be a better treatment modality as compared to CFMP for achieving true skeletal changes and minimal dental changes in cases with developing skeletal Class III with maxillary retrusion

Separation and pain perception of Elastomeric, Kesling and Kansal separators

Abstract Introduction: Various types of separators have been advocated, but the ideal separator should produce optimum separation with minimal pain and discomfort. Objective: The objective of this study was to evaluate and compare the amount of separation achieved by three different types of separators (Elastomeric, Kesling and Kansal), and to assess the associated pain and discomfort. Methods: A random single-blind split-mouth study was conducted on 108 patients seeking fixed orthodontic treatment, in which two different separators were used on each side in both the arches for a single patient. After five days, the amount of separation was measured with a feeler gauge. Visual Analogue Scale (VAS) scoring was performed by the patient on each day, to evaluate pain perception. Discomfort was evaluated by questionnaire filled by the patient at the time of separator removal. Results: The greatest amount of separation was seen with the elastomeric separators, while the smallest separation was seen with Kansal separators. VAS scoring showed maximum pain at day 1 with all the three separator types. Highest pain was perceived in the Elastomeric separators group, followed by Kesling and Kansal separators, respectively. Statistically significant difference was found in VAS score of Elastomeric separators, when compared to both Kesling and Kansal, on day 1 and 2 (p= 0.001). Analysis of the questionnaires revealed that a greater number of patients experienced discomfort with elastomeric separators placement (69.4%), which was statistically significant (p< 0.01) when compared to the other two types of separators. Answers to the other questions were comparable, except for the need for medications, which was reportedly highest with elastomeric separators. Conclusion: Kesling separators produce adequate separation with minimal discomfort and pain, compared to Elastomeric and Kansal separators